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Epidemio-Clinical, Therapeutic and Evolutive Aspects of Aortic Dissection in the Cardiology Department in Poin “G” Hospital University Center Bamako

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World Journal of Cardiovascular Diseases 2018年第8期8卷 424-430页

作者： Samba Sidibé Coumba Adiaratou Thiam Abdoul Karim Sacko Mamadou Diakite Mariam Dagnoko Souleymane Coulibaly Nouhoum diallo Hamidou Omar Ba Ibrahima Sangaré Somnoma Jean-Baptiste Tougouma Massama Konaté Oumar Daouda Koné Mamadou Touré Mariam Sako Ichaka Menta Illo Bela Diall Boubakar Diallo Cardiology Department Point “G” Hospital University Center Bamako Mali Cardiology Department Hospital Kati Bamako Mali Cardiology Department Gabriel TOURE Hospital University Center Bamako Mali Higher Institute of Health Sciences Nazi Boni de Bobo Dioulasso University Bobo Dioulasso Burkina Faso Cardiology Department Hospital Mali Bamako Mali Medical Department of Institute for Studies and Research Bamako Mali

Objective: The work aimed at describing an epidemioclinical, therapeutic and evolutionary characteristics of patients hospitalized for aortic dissection in the cardiology department in Point “G” Hospital University Center in Bamako—Mali. Methodology: It was a descriptive cross-sectional study from January 2010 to February 2017 in the CHU Point G cardiology department, including all patients hospitalized during this period. Results: Of 6912 hospitalized patients, 23 patients were concerned by aortic dissection. The prevalence of aortic dissection was 0.33%. The most affected age group was 50 - 69 (43.5%) of patients. The predominance was male with a sex ratio of 4.75. The cardiovascular risk factors were high blood pressure (73.9%) and smoking (60.9%). The major functional signs were chest pain (65.2%) and dyspnea (65.2%). Asphygmy (56.5%) and breath of aortic insufficiency (60.9%) were the dominant physical signs. The electrocardiogram recorded sinus tachycardia with 86.9% of patients. The radiographic of the frontal thorax showed mediastina widening (73.9%). At echocardiography, dilatation of the ascending aorta was described with 73.9% and the intimal veil (47.8%). Pericardial effusion was observed with 26.1% of patients. In the thoracic angioscan, the aortic dissection gave 43.5% for type A and 56.5% for type B. The aneurysm of the aorta was abdominal with 21.7%, ascending portion (13.0%) and descending with 8.7%. Complications were dominated by heart failure (47.8%) and aneurysm of the aorta (34.8%). The lethality was 52.2%. Conclusion: Aortic dissection is a medical and surgical emergency with poor prediction.

关键词： Aortic Dissection Cardiology Point G Hospital

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Contribution of the Medical Imaging in Care of Ambiguous Genitalia

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Open Journal of Radiology 2018年第2期8卷 125-130页

作者： Zanga Sore Moussa diallo Ousseini Ouattara boubakar Napon Aischa Madina Bamouni Yomboue Abel Cisse Rabiou Radiology Department of Charles de Gaulle Teaching Paediatric Hospital Ouagadougou Burkina Faso Radiology Department of Yalgado Ouédraogo Teaching Hospital Ouagadougou Burkina Faso

We report a case of ambiguous genitalia in a 15-year-old patient to demonstrate input of medical imaging in the diagnosis and care of this rare congenital deformation. Disorders of sexual differentiation (DSD) have been defined as congenital conditions in which development of chromosome, gonad, or anatomic sex is atypical and that raise an issue in the sex assignment. In lower socioeconomic countries where antenatal diagnosis is almost non-existent, due to lack of technical facilities, their medical and surgical management is hard. The case which we report was investigated by ultrasonography and genitography, which remains primary indications in our context.

关键词： Ambiguous Genitalia Karyotype Ultrasonography Genitography

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Cerebellar Syndrome Revealing a Giant Postero Inferior Cerebellar Artery Aneurysm: A Case Report and a Review of Literature

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Case Reports in Clinical Medicine 2021年第6期10卷 153-159页

作者： Oumar diallo Maiga Abdoulaye Hima Beketi Katanga Anthony Thioub Mbaye Mahamadou Dama Oumar Coulibaly Daouda Sissoko Alpha Singuepire Drissa Kanikomo Seydou boubakar Badiane Hospital of Mali Bamako Mali Hospital of Niamey Niamey Niger University of Kara Kara Togo University Checkh Anta Diop Dakar Senegal Regional Hospital of Segou Ségou Mali Hospital Gabriel Touré Bamako Mali

Context: Cerebellar syndrome caused by disturbances of balance and coordination is not an uncommon neurological disorder. It has varied etiologies usually caused by tumor processes or suppurative collections. Vascular causes remain very rare, especially when it is a giant aneurysm of PICA representing 1% of intracranial aneurysms. Treating giant PICA aneurysms is a very difficult task for neurosurgeons because the surgical dissection can lead to severe damage due to the intimate relationship of PICA with the brainstem or nerve structures. We report a case of giant PICA aneurysm responsible for cerebellar syndrome successfully treated with surgery. The objective of this work is to draw the attention of practitioners to this unusual cause which can lead to diagnosis wandering and a lack of planning at the time of management. Case report: A 65 years old hypertensive patient was seen for a progressive disturbance of balance and walking disorder, but worsened in the last three months with no notion of fever. On admission, the patient was lucid, oriented in time and space and presented with static and kinetic cerebellar syndrome. Brain CT-scan without and with contrast revealed a tissular mass in the posterior fossa suggesting a tumor process, however, CT angiography showed a giant aneurysm of the PICA after reconstruction. A careful microdissection by a sub-occipital approach was decided. Opening the large cistern made it possible to visualize the aneurysm sack surrounded by a yellowish gliosis. The reclining and microdissection revealed the neck of the aneurysm, which was clipped to exclude the giant aneurysm in block. Postoperative follow-up was simple with progressive improvement in the cerebellar syndrome and walking over three months. Conclusion: Giant aneurysm of the PICA is rare. The localization in the posterior cerebral fossa can be confusing. Microsurgery gives a good result.

关键词： Giant Aneurysm PICA Cerebellar Syndrome CT Angiography

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ECG and Echocardiography Findings: A Comparative Study between Sportive and Sedentary Female Patients (Bamako, Mali)

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World Journal of Cardiovascular Diseases 2019年第7期9卷 458-466页

作者： Ibrahima Sangaré Hamidou Oumar Ba Youssouf Camara Ichaka Menta Rokiatou Mété Noumou Sidibé Souleymane Coulibaly Fousseyni Coulibaly Aladji Traoré Illo Diall Lydia Berenice Sita Sangaré Boubakar Diallo Kassoum Mamourou Sanogo University Hospital Gabriel Touré Cardiology Bamako Mali University Hospital Sidy Bocar Sall Cardiology Kati Mali University Hospital Point G Cardiology Bamako Mali University Hospital for Odontostomatology Bamako Mali

Objective: To study cardiovascular cardiac and echocardiographic features in high-level footballers and sedentary women in Bamako. Materials and Methods: This was a cross-sectional study conducted in Bamako from April 2015 to March 2016 among 14 to 35 years old high-level footballers and a group of untrained women. Data including socio-demographic, physical examination, ECG record and echocardiogram was inserted in Microsoft Excel and analyzed with IBM SPSS. Chi Square and Fisher statistical tests were used to compare our results. The significance level was p 0.05. Results: Forty-three female subjects, 51% being sedentary were recruited. Mean age, weight and height were significantly higher in sportswomen than in sedentary women with respectively p of <0.0001, 0.003 and 0.036. Bradycardia was found in sports subjects in 28.6% and sedentary tachycardia in 18.2%. Left ventricular hypertrophy and dilatation and left atrial dilatation were predominant in sportswomen. Conclusion: Bradycardia, left ventricle hypertrophy and dilatation were found more in sportswomen. These changes acquired through physical training are aspects of cardiac adaptation that we found in our sample. Other aspects were not found probably due to the small size of the sample.

关键词： ECG Echocardiography Footballers Women Sedentary Bamako

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Prognostic Factors for Acute Heart Failure (AHF) in the Cardiology Intensive Care Unit (ICU) of the University Hospital Point G (UH Pt G)

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World Journal of Cardiovascular Diseases 2019年第1期9卷 42-50页

作者： Camara Youssouf Ba Hamidou Oumar Sangare Ibrahima Toure Karamba Coulibaly Souleymane Sacko Abdoul Karim Coulibaly Alfousseyni diallo Nouhoum Sidibe Samba Daou Adama Menta Ichaka Diall Ilo Bella diallo boubakar Abdoulaye University Hospital Sidy Bocar Sall Kati Mali University Hospital Gabriel Touré Bamako Mali University Hospital Point G Bamako Mali Disease Fighting Centers Bamako Mali

Background and Aim: The absence of data in our context motivates this study aiming to determine the frequency of AHF at the ICU, assess the in-hospital evolution of the disease and to find out poor prognosis.Material and Methods: It was an observational and descriptive study covering the time from January 1, 2014 to March 30, 2017 involving all inpatient records in ICU. From January 2014 to December 2017, collected data included those on socio-demographic, history of diseases and physical examination, and some labor dataincluding Pro BNP, serum creatinine, blood ionogram,?cardiac enzymes and blood count. Also data electrocardiography, echocardiography and in-hospital evolution were collected. Statistical Analysis:Statistical analysis was performed using SPSS (IBM Inc) version 18. Results: AHF occured in 47.36% with a mean age of 58.74 ± 18.407 and extremes of 17 and 90 years, women representing 53.1% (sex ratio Male:Female = 0.88). Hypertension and diabetes were the predominant cardiovascular risk factors with respectively 67.4% and 18.4%. At admission?44%, 37.7% and 17.9% of patients were respectively hypertensive,?normotensive and hypotensive. The clinical expression was mainly global heart failure with 42.6% followed by left heart failure and right heart failure with respectively 37% and 20.4%. The coronary syndromes (all forms) was the first cause of ICA with 34% of cases followed by pulmonary embolism and hypertension with respectively 25.3% and 24.1%. Mean hospital stay was 5.61 ± 3.527 days (1 to 25 days). Complications were recorded in 18.5% of patients with cardiogenic shock in half of all cases. In multi-variate analysis, only hypotension at admission was shown to be the independent factor of poor prognosis with p = 0.016 and OR = 4.453 (1.322 - 14.996). Conclusion: As a common manifestation heart failure can be rapidly fatal in presence of collapsus or hypotension at admission. These factors should be accurately managed to reduce mortality, which remains high in our context.

关键词： Acute Heart Failure Prognostic Factors Cardiology Intensive Care Unit Bamako

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Male Breast Nodules in Ouagadougou (Burkina Faso): Radiological and Histopathological Aspects

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Open Journal of Radiology 2018年第4期8卷 274-280页

作者： Nina-Astrid Nde Ouedraogo Madina Napon Bénilde Ma Kambou Tiemtore boubakar Ouattara Abel Bamouni Ousséini diallo Claudine Lougue Sorgho Rabiou Cisse Service of Radiology of the Hospital of Bogodogo District Ouagadougou Burkina Faso Service of Radiology of the Pediatric Teaching Hospital Charles de Gaulle Ouagadougou Burkina Faso Service of Radiology of the Teaching Hospital Yalgado Ouédraogo Ouagadougou Burkina Faso

Objective: To describe the radiological and histological aspects of breast nodules among men in our practice setting. Methodology: This is a descriptive and retrospective study conducted from January 2014 to October 2017. The study included male patients with breast nodules classified ACR3, 4 or 5 after a mammographic and ultrasound scan. These lesions were explored through an ultrasound-guided breast microbiopsy. The following are the variables collected: age, family history of breast cancer, medical history, ACR classification, nodule size, and anatomopathologic diagnosis. Results: 13 breast nodules were explored among 13 male subjects. Mammography and breast ultrasound enabled to identify one ACR3 lesion, 10 ACR4 lesions and 2 ACR5 lesions. The average age was 56.53 ± 14.63 years and the average size of the nodules 28.91 ± 13.62 mm. As for histology, there were seven malignant tumors and six benign tumors. The average age of patients with malignancy was 61.45 ± 13.62 years. The malignant nodules average size was 29.45 ± 12.54 mm. Malignant tumors exclusively consisted of invasive breast carcinomas while Benign ones consisted of dystrophic and inflammatory lesions. Conclusion: Most often Breast lesions among men had an indeterminate appearance on imaging and were predominantly malignant in histopathology.

关键词： Breast Microbiopsy Cancer Breast Male Benign Nodule

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Prognostic Factors Associated with Aortic Dissection at the Cardiac Intensive Care Unit of the Point “G” Hospital University Center, Bamako, Mali

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World Journal of Cardiovascular Diseases 2019年第9期9卷 657-664页

作者： Sidibé Samba Konaté Massama Thiam Coumba Adiaratou Coulibaly Souleymane Somnoma Jean-Baptiste Tougouma Dagnoko Mariam Sacko Abdoul Karim Sako Mariam Mariko Souleymane Diakite Mamadou Menta Ichaka diallo boubakar Cardiology Department Point “G” Hospital University Center Bamako Mali Cardiology Department Hospital Mali Bamako Mali Cardiology Department Hospital Kati Bamako Mali Higher Institute of Health Sciences Nazi Boni de Bobo Dioulasso University Bobo Dioulasso Burkina Faso Cardiology Department Hospital Tombouctou Tombouctou Mali Cardiology Department Gabriel TOURE Hospital University Center Bamako Mali

Objective: The purpose of this study was to describe the prognostic factors associated with aortic dissection with the cardiology intensive care unit of the Point “G” Hospital University Center. Methodology: This was a descriptive transversal study from January 2010 to February 2017 that included all inpatients during this period. Results: Of 6912 patients admitted, 23 patients were admitted for an aortic dissection, a frequency of 0.33%. Of these, (6) six were under age 50 (26.1%) and the majority age group was 50 - 69 years old. Cardiovascular risk factors were high blood pressure, smoking, and diabetes with 73.9%, 60% and 13% of cases, respectively. At the clinic, chest pain and dyspnea were the main symptoms with respectively 65.2% and 52.2% and with 56.5% asphygmy was associated with pain. Para-clinically, renal failure and anemia were the major laboratory abnormalities found with respectively 43.75% and 31.25% of cases. Doppler echocardiography revealed lesions associated with aortic dissection. In the thoracic angioscan, the aortic dissection was type A (43.5%) and 56.5% type B. The co-morbidities, the associated lesions and the hemodynamic state of the patient indicate the degree of urgency. The treatment was medical. The evolution was full of complications with 52.2% of deaths including 7 (seven) type A patients. Intra-hospital death was 26.1%. Other complications were heart failure (47.8%), the renal failure (43.75%) and an aortic aneurysm (34.8%). Conclusion: Aortic dissection is a life-threatening medical and surgical emergency.

关键词： Aortic Dissection Pronostics Bamako

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Anatomical Variants of Celiac Trunk in Relation to Its Branching: A Preliminary Sub-Saharan Study

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Open Journal of Radiology 2019年第2期9卷 151-161页

作者： Siaka Ben-Aziz Dao Ouattara boubakar Zanga Moussa Kambou Tiemtore Bénild Nde Ouedraogo Nina Ramde Annick Louazoube P. Gaï ba Zoungrana Robert diallo Ousseini Cissé Rabiou Centre Hospitalier Universitaire Yalgado Ouedraogo Ouagadougou Burkina Faso Centre Hospitalier Universitaire Charles de Gaulle Ouagadougou Burkina Faso Centre Hospitalier Universitaire de Bogodogo Ouagadougou Burkina Faso

Background: Surgical treatment of upper mesocolic organs is improved by preoperative diagnosis of anatomical variants of celiac trunk. According to the literature, these anatomical variants are little known in sub-Saharan Africa. Purpose: To evaluate the prevalence of anatomical variants of celiac trunk in relation to its branching. Materials and methods: This was a cross-sectional study of descriptive type. It retrospectively evaluated 160 abdominal contrast enhanced CT-scan, from patients attending Yalgado OUEDRAOGO teaching hospital, from 1 January 2015 to 30 September 2016. Patients with a history of heavy abdominal surgery were excluded. Images obtained by 64-row CT-scan were analyzed for anatomical variants of the celiac trunk. Results: One hundred and twenty-eight patients (80%) had a classic anatomical configuration of celiac trunk, while thirty-two (20%) had at least one anatomical variant. Two anatomical variants were found in fifteen patients (9.4%) while five other patients (3.1%) had more than two variants. The most frequent anatomical variant was the hepato-splenic bifurcation, found in fourteen patients (8, 8%). It was followed by common celiac and mesenteric trunk, and then collateral arteries, in particular left hepatic artery and right lower diaphragmatic artery, each with three patients (1.9%). Conclusion: Anatomical variants related to celiac trunk branching, are as frequent in our study as in the literature. However, the two most common anatomical variants were hepato-splenic bifurcation and common celiac and mesenteric trunk.

关键词： Celiac Trunk Anatomical Variant Hepato-Splenic Bifurcation Common Celiac and Mesenteric Trunk CT-Scan

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Preliminary Study on Renal Ultrasound Biometry in Apparently Healthy 18 to 30-Year-Old Subjects with Normal Renal Function in Ouagadougou

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Open Journal of Nephrology 2020年第4期10卷 388-402页

作者： Gérard Coulibaly boubakar Ouattara Gloria D. M. H. Capo-Chichi Tiéba Millogo Aïda H. Y. Lengani Aoua Semde Gaoussou Sanou Amidou Sawadogo Balkissa Ouattara Ousséini diallo Nephrology and Haemodialysis Department of Yalgado Ouedraogo University Hospital Center of Ouagadougou Ouagadougou Burkina Faso Imaging Department of Yalgado Ouedraogo University Hospital Center of Ouagadougou Ouagadougou Burkina Faso Health Sciences Research Institute Ouagadougou Burkina Faso Nephrology-Dialysis Department of Sourô Sanou University Hospital Center of Bobo-Dioulasso Bobo-Dioulasso Burkina Faso Omaha Nebraska USA

Introduction: In our practice, renal measurements in patients with normal renal function usually appear to be lower compared to standards reported in reference literature. The standards are probably different in our context. Given the importance of renal biometrics in nephrological practice, we felt it necessary to carry out this preliminary study in order to identify an order of reference measurements appropriate to our context. Methods: This was a cross-sectional study that took place from 18 August to 04 November 2018 at the Yalgado Ouedrarogo University Hospital Center. The first 100 subjects aged between 18 and 30 years who met the following inclusion criteria were selected: to be black african Burkinabe and to have normal renal function. The height, width and thickness of each kidney were measured using ultra-sound scanners. For statistical tests, a value of p Results: The average age was 23.9 ± 6.1 years and the sex ratio was 2.2. Mean heights, widths and renal thicknesses were 94.5 ± 14.5, 38.7 ± 10.7 and 36.3 ± 10.3 mm, and 96.7 ± 16.7, 42.7 ± 16.7 and 36.8 ± 10.8 mm respectively for right and left kidneys. The distribution of the different renal dimensions in our sample followed a normal distribution. In the particular case of the right kidney, the probability that its height was between 79.2 and 109.7 mm was 0.95 and the probability that it was less than 79.2 mm or greater than 109.7 mm was 0.05. Renal height was significantly higher in subjects with height greater than 1.70 m (p ≤ 0.02). The left kidneys were on average significantly larger than the right kidneys (p = 0.0001). Conclusions: Our study is not extrapolable to the general population of Burkina Faso. It suggests, however, that the kidneys of the apparently healthy Burkinabe subject are smaller than what is reported in anatomy reference books. Our work, which is preliminary, should be deepened through a national survey. In the

关键词： Black African Burkina Faso Renal Biometrics Ultrasounds Scanner

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Radio-Histopathological Aspects of Breast Nodules in a Sub-Saharan African City (Ouagadougou, Burkina Faso)

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Open Journal of Medical Imaging 2018年第3期8卷 89-96页

作者： Nina-Astrid Nde Ouedraogo Bénilde Ma Kambou Tiemtore Yobi Alexis Sawadogo boubakar Ouattara Prosper David Lamien Madina Napon Ousséini diallo Abel Bamouni Claudine Lougue Sorgho Rabiou Cisse Radiology Department of Charles de Gaulle Teaching Paediatric Hospital Ouagadougou Burkina Faso Gynaeco-Obstetric Department of Bogodogo Teaching Hospital Ouagadougou Burkina Faso Radiology Department of Yalgado Ouedraogo Teaching Hospital Ouagadougou Burkina Faso Radiology Department of Charles de Gaulle Teaching Paediatric Hospital Ouagadougou Burkina Faso

Objective: To determine the diagnostic contribution of breast microbiopsy percutaneously under ultrasound guidance. Methodology: Retrospective descriptive study conducted from January 2014 to October 2017. The included patients had an ultrasound-guided breast microbiopsy after a mammographic and ultrasound scan. The variables collected were gender, age, nodule size, ACR classification and anatomopathologic diagnosis. Results: 347 nodules were explored in 313 patients. There were 300 women (95.85%) and 13 men (4.15%), a gender ratio of 23.07. The average age was 44.64 ± 14.18 years. The average size of the nodules was 30.33 ± 19.58 mm. There were 53.89% ACR4 grade nodules, 48% ACR5 nodules and 32.28% ACR3 nodules. 86.49% of ACR3 nodules were benign and 97.92% of ACR5 nodules were actually malignant. Malignant tumors accounted for 50.29% of the nodules and were dominated by invasive breast carcinomas in 98.26%. The average age of patients with malignant tumors was 49.15 ± 11.55 years. 16% of patients with malignancy were aged under 40 years old. Conclusion: The diagnostic yield was satisfactory and there was a good correlation between the rate of malignant and benign lesions and the positive predictive values of malignancy in the literature.

关键词： Breast Microbiopsy Ultrasound Guidance Mammary Nodule Breast Cancer

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